Hello, it's Anthony Chadwick from the webinarett welcoming you to another episode of Vet Chat. This one is gonna be slightly expiggated. We're really wanting to just talk to Ian Ramsey, professor at.
Glasgow University and lucky, unlucky enough to have had me as a fellow student at Liverpool University, so it's always great to see you Ian. But you're gonna be talking about a very important topic, the whole area of antibiotic resistance, but particularly this very practical step that's happening in November 2023. Yes, that's right, Antony.
I'm going to be talking about the antibiotic amnesty that we're running in November 2023. This amnesty is the idea is that we ask clients to bring back their unused antibiotics. We know from surveys of both veterinary clients and from human patients that significant.
Numbers of people will retain antibiotics in their house after the course has stopped, either because they have felt better, or they've just forgotten to keep on taking them, and they'll keep those antibiotics for later use, sometimes on their themselves, sometimes on their patients, sometimes on on on other animals in the household. Or, they will use them, and sorry, or they will not use them and then throw them away either in the domestic waste. Or worse still, they flushed them down the toilet.
This used to be standard advice for all pharmaceuticals to flush them down the toilet if you didn't use them, with the result that many of our rivers have become contaminated. With antibiotics and other pharmaceuticals, and surveys of the rivers of the world have shown that very significant amounts of pharmaceutical product are in those rivers, and if we try to get them back from our clients, to be disposed of properly, we will reduce environmental contamination. Environmental contamination leads to low levels of antibiotic in the environment, leads to antimicrobial resistance in the environment, which can then transfer back to us.
We, we actually find them in sewage farms, don't we, sort of anti anti microbes, er sorry, microbes that are resistant to antibiotics. Very much so, very much so. The, the, we, one of the ways we monitor antimicrobial resistance is by looking at at the output of sewage farms, it's not a research project.
I particularly, I would like to get involved with, but there are people who go around sampling these sewage farms and they find very high levels of resistant microbes because they're being exposed to low levels of antibiotics as well as people excreting them and the net result of that, unfortunately in the UK, of course, as you know, we have a problem with our, our sewage outflow into into the environment. And, and what we find is that that people who are surfing in the waters of the UK have a much, much higher rate of, multi-drug resistance organism carriage than the regular members of the public, up to 3 times that rate, and that reflects the fact that they, they are essentially surfing in dilute sewage. The, the good thing about this amnesty is it it is another example of One Health where the NHS and veterinary practises and pharmacies are working together, which is absolutely fantastic.
But at the same time, obviously a lot of vet practises are very busy, and it can be very easy to say, you know what, this is kind of. On a list of problems, but it's fairly low on my priority list. Having said that, I think it, it can be a very easy thing to do, can't it?
So if you just perhaps want to explain to people how this is actually gonna work out in a practical sense and how much time this is gonna be for practises to commit. OK, so, first of all, if, if it is low on your priority list, it it that should change. There is an RCVS requirement that all practises engage in efforts to try to get back pharmaceutical waste, .
It is a clear part of of the core basic practise standards, so if that possibly might boost it a little bit higher up people's list anyway. This is a new requirement, but a good one, I think. So how do you go about it?
The first thing to do for the amnesty is to get yourself a disposal of old pharmaceuticals bin, a dupe bin, any plastic tub will do, and put it somewhere where it's safe and secure. Then You ask your clients to bring back the out of date antibiotics, indeed all out of date pharmaceuticals, but out of date antibiotics is our particular focus. And the ways to do this are through your practise Facebook site, through notices in your reception, through asking your receptionists to remind people, to ask your nurses when they're handing over antibiotics or other tablets to, to clients saying, do you have any out of date drugs left?
We're trying to get those back and explaining why, to protect the environment, we're trying to get all these old drugs back. This is not for resale, this is for safe disposal. And of course, every vet, every time they write a prescription or hand over drugs should be doing the same, and that's all you need to do is just say, have you got any old drugs left that you can get back for correct as well.
We want to dispose of them properly. And at the end of the month. Collect all this stuff in a bin and then write into us and there's a survey that that we can make available to you, a survey to try to find out how many drugs we've got, how many antibiotics we've got back, during the month of November.
This survey has some wonderful prizes in it if you take part, a free membership of Webinar vet, a free congress at BSAVA to name two. So so it's well worth your while entering these things anyway, and of course there'll be a lot of noise on social media, from webinar vet, from BSAVA, from BVA, from the corporates and so forth. Everyone's getting behind this, so there'll be a lot of, additional information out there to help you, but it really does start with your vets, your nurses, and your receptionists just asking the question.
Do you have any old drugs in your house? If so, please can we have them back? And I think this has been organised by rumour, but obviously with the support of organisations like Webinarett and BSABA.
So I presume rumour also has some resource resources on their website that people can go to as well. Yeah, absolutely we we we we've got a whole website for this but RUMA is a sort of coordinating body for antimicrobial stewardship in in the UK as you know, and there's a. Companion Animal branch and they have a a website which is full of resources, including little useful things like stickers that you can stick on drugs, packages when they go out saying please bring back unused drugs.
It's, it's, it's a really easy thing that so so at Glasgow vet school, we've just taken all our little white cardboard boxes and we've just stuck stickers on them. That's an easy communication and please bring back unused drugs. Those sticker designs are, are there, unfortunately, you're going to have to order the stickers.
You can get them really cheap off off Amazon, not I'm plugging Amazon, but you can just buy the, buy the stickers, use the sticker design that we've given you. It really is a 5 minute job to order 600 stickers, and that can get out to all your clients. And, and although this is obviously a November thing actually, as you're saying with the Royal College, it's, it's actually good practise and it's not only helping the environment, but obviously we're all part of the world, so it's obviously all animals, plus also people.
We, we think that potentially, you know, millions of lives could be lost because of antibiotic resistance in the future. We already know there are people who are dying because, they have infections that can't be controlled with antibiotics, so this is something, the quicker that we do something about it, the better. Yeah.
I it's, it's a, it's low hanging fruit, it's easy. It's something that we can do right now that, that helps the environment, it helps animals, it helps us, and, and it costs nothing to do that. It's just a question of asking.
People for their antibiotics back and then using the normal disposal channels to to do this, which you need to do so anyway, it's not an additional cost, this is a cost you should be paying anyway, and it it helps protect the environment. And, what we'll do is at the end of the podcast, if people listen or look at the the writing below, we'll have put the relevant links in for things like the rumour site and so on. And so, so just to recap, obviously they start actually getting the box out there to actually collect the antibiotics and other pharmaceuticals that are out of date.
Obviously the main focus is antibiotics. You were saying about at the end of the month, recording those, but are you thinking more about the volume that you've taken back rather than individual, cos individual tablet counting would be. That that depends on what you've got back in during the last survey we had people reporting that they've got 28 potentialated amoxicillin back tablets and other people said a box, the, the survey allows you to do both, we've got, you know, places for you to record ointments and creams and, oral suspensions.
It's, it's more a record of activity that we know roughly what's going on than that we actually need. Specific milligrammes of of of active ingredient that's clearly a calculation beyond which we we don't really need what what we need to do is to is to kick start this process of getting these drugs coming back to us. It it it it would be great if as a result of all this, clients started to learn the habit that when you've got drugs that you don't need, you bring them back rather than put them down the toilet or put them in the bin.
You bring them back to where you got them from, and the involvement of the NHS in Scotland and in the Midlands has been a huge boost to this the the the whole scheme started in in NHS Midlands. I'm pleased that Scotland's come in as as well. We're hoping that other NHS regions will slowly start to pick this up, but, just as the veterinary profession is short of time, so are community pharmacies, so are our community practises.
And, getting their agreement is, an involvement is clearly a, a key step for the future. And I know last year was the first year as far as we were that the vets were involved, and I, I suppose that the key is it would be great to see the number of practises that were involved last year increase this year. So I think it's a really, really important initiative.
Ian, I know you've been very involved in it, so thank you for all the hard work that you and and others like Fergus Allerton have have done. But really we just need our, our practises to step up and to start collecting and and a bit like our veterinary green discussion forum, which we're going to run till 2030, each year you hope that the momentum gets bigger and bigger, you have the early adopters with all of these type of schemes, and then you get the kind of, you know, the general practises, you know, the, the, the sort of. The masters, if you like, and then of course at the end with all of these, you have the laggards who just don't want to do it.
But eventually get forced to do it because of legislation and things, so it would be great to see an increase in numbers from last year to this year, and I know that when the Amnesty is finished, perhaps in the early new year we're gonna do. A round table just to sort of summarise what's happened and some of the, the results that we've had as well at Webinarett, so I'm, I'm looking forward to chatting again with you to see the successes that we've had with this scheme. Great, thank you very much.
Thanks Ian, thanks everyone for listening. A slightly shorter one, which is amazing when you've got Ian and me in the room that we haven't gone on to other tangents, but this is obviously a really important area. I'd love you to support it and as Ian was saying, if you answer the survey at the end, your name will be put in a hat, provided you've given your details, and there are some nice prizes like the BSAVA Congress ticket, which is always a, A fabulous congress and we've also agreed to chip in with an unlimited membership and I know there are some other prizes as well, so do, if you, you've got to be in it to win it as they say, so do, do get involved in the amnesty.
This is a really important area and looking forward to hearing the results soon. OK, thanks a lot, Antony. Thanks everyone for listening.
This has been Anthony Chadwick at the Webinar vet, and this has been Be Chat. Thank you.
